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Archive for the 'mood disorders' Category

Postdoc leaves academia (fMRI emotion research). “I actually ran into that process in three different labs, two of which were at TopUniversityA with PIs who I highly revered and respected. It’s just how it goes in those fields…remove all of the negative results, don’t actually report the ridiculous number of fishing expeditions you went on (especially in fMRI research), make it sound like you mostly knew what you were going to find in the first place, make it a nice clean story. When my colleagues (from a well-known, well-respected emotion research lab) were trying to talk me into removing all of the negative results and altering what my original hypothesis was, literally saying “everyone does it…” that was it for me. I had a sinking feeling that everyone did do it that way and that I couldn’t trust the majority of work I had to depend on/reference myself. The level of denial in psychology and human neuroimaging research that this process just clogs the system with useless BS is something I just can’t stomach.” Devastating criticism — especially finding the same thing in three different labs. I believe nothing involving fMRI and psychology. My friend Hal Pashler wrote about this. At UC Berkeley, the fMRI machine used by psychology researchers malfunctioned for years. Nobody noticed. Only when someone from UC Davis got different results at Berkeley was the problem detected.

In 1995, hoping to improve my sleep, I decided to watch TV early in the morning, for reasons explained here. One Monday morning I watched tapes of Jay Leno and David Letterman that I’d made. Nothing happened. On Tuesday, however, I woke up and felt great: cheerful, eager and yet somehow calm. I had never felt so good so early in the morning. Monday had been a normal day, I had slept a normal length of time. The good feeling was puzzling. Then I remembered the TV I had watched. It had seemed so innocuous. The notion that 20 minutes of ordinary TV Monday morning could make me feel better Tuesday but not Monday seemed preposterous. Absurd. Couldn’t possibly be true.

Except for one thing. I had done something to improve my sleep. Plenty of research connected sleep and depression. That research made it more plausible that something done to improve sleep would improve mood. I went on to confirm the morning faces/mood linkage in many ways. The research connecting sleep and depression had been the first signs of a hidden mechanism (we need to see morning faces for our mood regulatory system to work properly) I consider very important.

Two new studies further connect sleep and depression. One of them found that people who sleep normal amounts of time are less influenced by genes associated with depression than those who sleep longer or shorter lengths of time. The other found that teenagers who sleep less than usual are at greater risk of depression.

The theories that psychiatrists have used to justify anti-depressants (e.g., “chemical imbalance”) do not explain the many connections between sleep and depression. Depression is associated with lots of bad things, unsurprisingly, but the association with bad sleep is especially strong. It is not easily explained away. You might think that if you are depressed you are more tired than usual and therefore sleep more/better than usual. The opposite is true. All this might have generated, among psychiatric researchers, a search for a better theory — an explanation of depression that can explain the sleep/depression connections — but it hasn’t.

Because of cold weather in America, Longform (the website) linked to a 1995 article about the death by freezing of Teresa McGovern, daughter of George McGovern. She was drunk and fell down. Her alcoholism was intractable. She went for treatment dozens of times. I have a theory about what causes alcoholism and other addictions and why they resist treatment. (more…)

I want to summarize what I’ve learned about how to sleep well. I’ve found about a dozen changes that helped. Taken together they suggest the importance of four dimensions:

1. Healthy brain. My sleep greatly improved when I ate a lot of pork fat. (As far as I can tell, butter produced the same effect.) I wasn’t getting enough animal fat. My sleep also improved when I started eating honey at bedtime. I assume honey raised blood sugar to better levels during sleep, improving brain performance. The great importance of this, I believe, is why we evolved preferences that push us to eat strongly sweet foods, such as fruit, separately and later, i.e., dessert. Bedtime honey also caused my muscles to grow more in response to exercise — a sign of better sleep, since muscles grow during sleep. I have never measured the effect of flaxseed/flaxseed oil on my sleep but the brain benefit was so clear in other ways I’d be surprised if it didn’t improve sleep. (more…)

In 1995, I discovered that seeing faces in the morning raised my mood the next day. For example, seeing faces Monday morning improved my mood on Tuesday (but not Monday). Study of the effect suggested we have a face-sensitive oscillator that controls mood and sleep. The oscillator needs morning-face exposure to work properly — faces “push” the oscillator as you would push a swing. Long ago, this oscillator synchronized the mood and sleep of people who lived together. The synchronization helped them cooperate. It is much easier to work with a happy person than an unhappy person and, of course, much easier to work with someone awake than someone asleep.

My results suggested you need to see morning faces on the order of 30 minutes to get a big effect. The faces need to be similar to what you’d see in a conversation. Looking at people on the subway doesn’t count. Nowadays, as far as I can tell, hardly anyone gets the right input. In extreme cases, this causes depression, poor sleep, bipolar disorder, and anxiety disorders. What else might it cause? (more…)

Fully 1 in 5 Americans take at least one psychiatric medication. Yet when it comes to mental health, we are facing a crisis in drug innovation. . . . Even though 25 percent of Americans suffer from a diagnosable mental illness in any year, there are few signs of innovation from the major drug makers.

The author has no understanding of the stagnation, yet is opinionated:

The simple answer [to what is causing the stagnation] is that we don’t yet understand the fundamental cause of most psychiatric disorders [what does “fundamental cause” mean? — Seth], in part because the brain is uniquely difficult to study; you can’t just biopsy the brain and analyze it. That is why scientists have had great trouble identifying new targets for psychiatric drugs.

The great increase in depression has an environmental cause. Meaning that depressed brains (aside from the effects of depression) are the same as non-depressed brains. Someone who knows that would not talk about biopsying the brain.

You come to a room with a door. If you don’t know how a door works, you are going to do a lot of damage getting inside. That is modern psychiatry. I described a new explanation for depression in this article (see Example 2).

A friend of mine knows a former (retired) head of psychological services at Princeton University. She told him that in the 1970s, there were one or two suicidal gestures per year. Recently, however, there have been one or two per day.

Something is terribly, horribly wrong. Maybe the increase is due to something at Princeton. For example, maybe new dorms are more isolating than the old dorms they replaced. Or maybe the increase has nothing to do with Princeton. For example, maybe the increase is due to antidepressants, much more common now than in the 1970s.

Whatever the cause, tt would help all Princeton students, present and future, and probably millions of others, if the problem were made public so that anyone, not just a vanishingly small number of people, could try to solve it. It isn’t even clear that anyone is trying to explain/understand/learn from the increase.

Princeton almost surely has records that show the increase. If, as is likely, Princeton administrators never allow the increase to be documented, it will be a tragedy. It is an extraordinary and unprecedented clue about what causes suicidal gestures. Nothing in all mental health epidemiology has found a change by factor of a hundred or more — much less a mysterious huge change.

The increase is an unintended consequence of something else, but what? Because it is so large, there must be something extremely important that most people, or at least Princeton administrators, don’t understand about mental health. The answer might involve seeing faces at night. I found that seeing faces in the morning produced an enormous boost in mood and that faces at night had the opposite effect. I cannot say, however, why seeing faces at night would have increased so much from the 1970s to now.

At 10 am, I NCd [nose-clipped] a cup of milk, coffee and 2 small spoons of butter (I really like the anti-depressant effects of butter so I am making it part of my breakfast every day)

I noticed something similar the first time I ate a lot of butter (about 60 g). It was at lunch. A few hours later I felt a pleasant warm feeling in my head. The butter was the only unusual thing I had eaten.

Interview with Royce White, the basketball player. I agree with him that addictions should be considered mental disorders. I think they are usually self-medication for a mood disorder, such as depression. His view that more than half of Americans have a mental disorder is consistent with my view that you need to see faces in the morning to have your mood control system work properly. Hardly anyone sees enough faces in the morning.

Racial quotas at Harvard by Ron Unz. “Top officials at Harvard, Yale, and Princeton today strenuously deny the existence of Asian-American quotas, but their predecessors had similarly denied the existence of Jewish quotas in the 1920s, now universally acknowledged to have existed.”

Adam Lanza, the Sandy Hook shooter, was taking medication, according to a neighbor. Here’s what someone said in 2008: “Every young, male shooter [who] has gone on a killing spree in the United States also has a history of treatment with psychotropic drugs — typically SSRI antidepressants. These shootings have three things in common: 1) The shooters are young males. 2) The shooters exhibit a mind-numbed disconnect with reality. 3) The shooters have a history of taking psychiatric medications.”

Lanza was considered by his mom to have Asperger’s. No doubt that, and the associated isolation, had something to do with the medication. As I point out every year at Nobel Prize time, the research methods favored by the healthcare establishment have done little to reduce major diseases, such as depression. With few exceptions, year after year little progress is made on figuring out the environmental cause of anything, including Asperger’s and autism. The result of this lack of progress is that almost every serious health problem, including mental health problems, gets treated with drugs or surgery rather than prevented or treated safely with necessary nutrients (as scurvy is treated with lime juice). The little progress that is made in finding environmental causes is undervalued. The researchers who figured out that smoking causes lung cancer didn’t even get a Nobel Prize. The effect of failing year after year to find environmental causes is that people take more and more drugs with little-known or unknown side effects, which are almost always bad. The association of SSRI antidepressants and violence is still unknown to many people, for example. The problem has been made worse by drug companies hiding data. As Ben Goldacre says in Bad Pharma, one of the worst cases involved an antidepressant called paroxetine, whose manufacturer (GlaxoSmithKline) withheld data about its tendency to cause suicide. My work has suggested that a lot of depression may be due to lack of exposure to faces in the morning, an idea utterly different than the neurochemical theories of depression favored by psychiatrists. I am sure that seeing faces in the morning is safer than taking psychiatric drugs.

Here at Tsinghua University, the Second Annual Chinese International Conference on Positive Psychology has just begun. The first speaker was Martin Seligman, a professor at the University of Pennsylvania and former president of the American Psychological Association (the main professional group of American psychologists). Seligman is more responsible for the Positive Psychology movement than anyone else. Here are some things I liked and disliked about his talk.

Likes:

1. Countries, such as England, have started to measure well-being in big frequent surveys (e.g., 2000 people every month) and some politicians, such as David Cameron, have vowed to increase well-being as measured by these surveys. This is a vast improvement over trying to increase how much money people make. The more common and popular and publicized this assessment becomes — this went unsaid — the more powerful psychologists will become, at the expense of economists. Seligman showed a measure of well-being for several European countries. Denmark was highest, Portugal lowest. His next slide showed the overall result of the same survey for China: 11.83%. However, by then I had forgotten the numerical scores on the preceding graph so I couldn’t say where this score put China.

2. Work by Angela Duckworth, another Penn professor, shows that “GRIT” (which means something like perseverance) is a much better predictor of school success than IQ. This work was mentioned in only one slide so I can’t elaborate. I had already heard about this work from Paul Tough in a talk about his new book.

3. Teaching school children something about positive psychology (it was unclear what) raised their grades a bit.

Dislikes:

1. Three years ago, Seligman got $125 million from the US Army to reduce suicides, depression, etc. (At the birth of the positive psychology movement, Seligman proclaimed that psychologists spent too much time studying suicide, depression, etc.) I don’t mind the grant. What bothered me was a slide used to illustrate the results of an experiment. I couldn’t understand it. The experiment seems to have had two groups. The results from each group appeared to be on different graphs (making comparison difficult, of course).

2. Why does a measure of well-being not include health? This wasn’t explained.

3. Seligman said that a person’s level of happiness was “genetically determined” and therefore was difficult or impossible to change. (He put his own happiness in “the bottom 50%”.) Good grief. I’ve blogged several times about how the fact that something is “genetically-determined” doesn’t mean it cannot be profoundly changed by the environment. Quite a misunderstanding by an APA president and Penn professor.

4. He mentioned a few studies that showed optimism (or lack of it) was a risk factor for heart disease after you adjust for the traditional risk factors (smoking, exercise, etc.). There is a whole school of “social epidemiology” that has shown the importance of stuff like where you are in the social hierarchy for heart disease. It’s at least 30 years old. Seligman appeared unaware of this. If you’re going to talk about heart disease epidemiology and claim to find new risk factors, at least know the basics.

5. Seligman said that China had “a good safety net.” People in China save a large fraction of their income at least partly because they are afraid of catastrophic medical costs. Poor people in China, when they get seriously sick, come to Beijing or Shanghai for treatment, perhaps because they don’t trust their local doctor (or the local doctor’s treatment failed). In Beijing or Shanghai, they are forced to pay enormous sums (e.g., half their life’s savings) for treatment. That’s the opposite of a good safety net.

6. Given the attention and resources and age of the Positive Psychology movement, the talk seemed short on new ways to make people better off. There was an experiment with school children where the main point appeared to be their grades improved a bit. A measure of how they treat each other also improved a bit. (Marilyn Watson, the wife of a Berkeley psychology professor, was doing a study about getting school kids to treat each other better long before the Positive Psychology movement.) There was an experiment with the U.S. Army I couldn’t understand. That’s it, in a 90-minute talk. At the beginning of his talk Seligman said he was going to tell us things “your grandmother didn’t know.” I can’t say he did that.

When I read in August that the talented Hollywood film director Tony Scott had killed himself without any apparent good reason, I was fairly sure that pretty soon we would find that the poor man had been taking ‘antidepressants’. Well, a preliminary autopsy has found ‘therapeutic’ levels of an ‘antidepressant’ in his system. I take no pleasure in being right, but as the scale of this scandal has become clear to me, I have learned to look out for the words ‘antidepressant’ or ‘being treated for depression’ in almost any case of suicide and violent, bizarre behavior. And I generally find it. The science behind these pills is extremely dubious. Their risks are only just beginning to emerge. It is time for an inquiry.

“Tony Scott Suicide Remains a Mystery After Autopsy,” wrote a Vanity Fair editor. The autopsy found that he had been taking the antidepressant Remeron, whose known side effects include suicide. SSRI’s, of which Remeron is an example, cause suicidal thinking in people who are not depressed.

The psychiatrist David Healy was the first to emphasize this point. In 2000, after he began this research, he was offered a job at the University of Toronto. In a very unusual move, the job offer was rescinded. Apparently psychiatry professors at the University of Toronto realized that Healy’s research made the psychiatric drug industry look bad.

I don’t think it’s wrong to sell drugs that improve this or that condition (e.g., depression), even if the improvement is slight. I do think it’s wrong to make false claims to induce people to buy the drugs. In the case of depression, the false claim is that depression is due to a “chemical imbalance.” No chemical difference has ever been shown between people who later become depressed and people who don’t later become depressed. This claim, repeated endlessly, makes it harder to do research into what causes depression. If you figured out what caused depression, you could treat it and prevent it much better. This false claim does enormous damage. It delays by many years discovery of effective treatment and prevention of depression, a disease from which hundreds of millions of people now suffer.

This happens in dozens of areas of medicine. Dermatologists say “acne is caused by bacteria“. Most doctors appear to believe “ulcers are caused by bacteria”. Ear nose and throat surgeons claim that part of the immune system (the tonsils) causes illness. The “scale of the scandal” — medical school professors either (a) don’t understand causality or (b) deceive the rest of us — is great.

It was generous of Sady Doyle, a New York writer in her thirties, to use her real name when writing about her bipolar disorder for Rookie, the website for teenage girls. (“Because of this article, you’ll always be able to Google me and find out that I have this sickness.”) It is what I expect from Rookie to post this sort of thing — I was a big fan of Sassy, an earlier magazine for teenage girls that tried hard to be truthful. But I was surprised to see this:

Here’s the part of the story that matters: once I got the diagnosis, got the pills, and got in touch with a therapist I really liked, I woke up in the morning. And I was happy, genuinely happy, for the first time in a very long time. That’s what matters about my nervous breakdown—or yours, or anyone’s. When I got the help I needed, I was able to recover.

Okay, that’s what happened, as Brave New Worldish as it may sound. But is it true “that’s what matters” — meaning that’s all that matters? No, I don’t think so. I think it also matters (a lot) that Doyle has been told she must take pills (such as lithium) for the rest of her life and those pills usually have bad side effects (lithium causes weight gain, for example). It is seriously misleading for Doyle to fail to make these points. Doyle vaguely implies she has been told she will need to take pills for “a long time”, which is an understatement, and says nothing about side effects. Maybe she omitted this stuff because she didn’t want her readers “to be afraid to seek treatment” (as she might put it). That is the opposite of truth telling.

Thirty years of bipolar disorder taking virtually every possible anti-depressant over time, and at times when hospitalized, forced to take them under the duress of threatened sectioning under the Mental Health Act. Throughout those years I told the psychiatrists that the drugs didn’t work beyond an initial “placebo effect” lasting about 2 weeks, and that the side effects were often awful.

I am not saying bipolar disorder drugs are worthless. I am saying they have bad side effects so often that any description of what it’s like to have bipolar disorder that makes claims of universality (“That’s what matters about my nervous breakdown—or yours, or anyone’s”) should point this out.

My last post described how Navanit Arakeri found that looking at faces on his iPad in the morning improved his mood. Three things struck me about his experience.

1. Small faces worked (“much smaller than life-sized”). I found that life-size faces produced the biggest effect. I never studied the effect of face size in detail (trying many different sizes). I first experienced the effect after watching Jay Leno do his monologue on a 20-inch TV — much smaller than a life-size face. Obviously we recognize faces when they are much smaller than life-size. For example, we recognize faces in newspaper photos. And we recognize people at a wide range of distances, meaning that the retinal image of a face can vary greatly in size without preventing recognition. Both facts suggest that the size of the face may not matter a lot for this effect.

2. He watched right after he got up. There is surely a window of effectiveness — a time period outside of which the faces do nothing — but when? And how long? I don’t know. It surely depends on your exposure to sunlight, which is incredibly hard to measure. Navanit found a simple rule that worked (“watch right after you get up”). When I first experienced the effect I did the same thing that works for him — I watched TV a few minutes after I woke up.

3. He became less irritable (“much more emotionally resilient to irritants and bad news”). I noticed the same thing. A paradox of depression is that people become more irritable. Depression is a disease of passivity — you don’t want to do anything — but irritability is over-reaction. I’ve heard it claimed that depression may be caused by not eating enough fruits and vegetables. Okay, lack of a vital nutrient might cause people to have less energy, but why would it make them more irritable? Not obvious. The fact that the morning-faces effect includes this component is part of why I think it sheds light on what causes depression. Perhaps anything that raises your mood will make you less irritable but I can only say it didn’t feel that way — it felt like something special. Like everyone else I have my mood raised by ordinary events (e.g., good news, a joke) and these do not seem to produce a big increase in serenity.

Thank you, it’s the most extraordinary thing. It’s taken my average daily mood from 6/10 to about 8/10 [on a 1-10 scale where 1 = very, very bad mood, 5 = neutral, and 10 = amazingly good mood. 6/10 = just better than neutral and 8/10 = very good. Note: if 5 = neutral, then a 1-9 or 0-10 scale will work better than a 1-10 scale] It has made me officially “happy”. And much more emotionally resilient to irritants and bad news.

I do it on waking at around 8:00 AM every day. I play “morning news” videos on mute on my iPad with no zoom (so it’s much smaller than life-sized). Example video

I do it for only 20-40 minutes, usually around 25 minutes. I’ve been doing it for about 45 days now.

I’m seeing a few interesting differences compared to your experience:

1. I don’t get the evening irritability at all. In fact, sometimes I get a Big Mood Improvement (see #2) in the evening (around 8:00 PM). The evening effect doesn’t happen every day, while the morning improvement is much more consistent.

2. Sometimes the mood improvement is so strong that I have an involuntary smile on my face. I can sit and stare into space feeling very happy. . . .

How long before he could tell it was working? “It was very clear by the 3rd morning,” he said.

He recorded the “involuntary smile” states, which lasted 30-60 minutes, on his iPhone. This graph shows how often they happened versus time of day over a 33-day period:

A value of 8, for example, means that there was roughly a one-quarter chance that during that time period he would be in the “involuntary smile” state. Before this the likelihood of involuntary smiles was zero.

1. Drinking sugar water causes weight loss. The self-quantification was measuring my weight. It began when I found a new way to lose weight, which pushed me to try to explain why it worked. The explanation I came up with — a new theory of weight control — made two predictions that via self-experimentation I found to be true. That gave me faith in the theory. Then the theory suggested a really surprising conclusion, that loss of appetite during a trip to Paris was due to the sugar-sweetened soft drinks I had been drinking. If so, drinking sugar water should cause weight loss. (The nearly-universal belief is that sugar causes weight gain, of course.) I tested this prediction and it was true. More.

2. Seeing faces in the morning improves mood the next day (but not the same day). This is so surprising I’ll spell it out: Seeing faces Monday morning improves my mood on Tuesday but not Monday. For years I measured my sleep trying to reduce early awakening. Finally I figured out that not eating breakfast helped. There was no breakfast during the Stone Age; this led me to take seriously the idea that other non-Stone-Age aspects of my life were also hurting my sleep. That was one reason I decided to watch to watch a certain TV show one morning. It had no immediate effect. However, the next morning I woke up feeling great. Via self-measurement of mood, I determined it was the faces on TV that produced the effect, confirmed the effect many times, and learned what details of the situation (e.g., face size) controlled the effect. More.

4. Butter is healthy. I found that butter improved how fast I can do arithmetic problems. No doubt it improves brain function measured in other ways. Because the optimum nutrition for the brain will be close to the optimum nutrition for the rest of the body — at least, this is what I believe — I predict that butter will turn out to be healthy for my whole body, not just my brain.

5. Mainstream Vitamin D research is all messed up. Via self-measurement I confirmed Tara Grant’s conclusion that taking Vitamin D3 in the morning (rather than later) improved her sleep. It improved my sleep, too. When I had taken it at other times of day I had noticed nothing. Apparently the timing of Vitamin D — the time of day that you take it — matters enormously. Take it at the right time in the morning: obvious good effect. Take it late in the evening: obvious bad effect. Vitamin D researchers haven’t realized this. They have neither controlled when Vitamin D is taken (in experiments) nor measured when it is taken (in surveys). Because timing matters so much it is as if they have done their research failing to control or measure dose. If you fail to control/measure dose, whatever conclusion you reach (good/no effect/bad) depends entirely on what dose your subjects happened to take. And you have no idea what dose that is.

A friend of mine has been using morning faces therapy to improve his mood — he suffers from bipolar disorder — for 15 years. He is the first person I told about it. I recently asked him how his use of it has changed over the years. He replied:

I began the morning faces therapy in April, 1997. I can think of only two significant changes over the years in my use of the therapy: 1) I use a mirror instead of videotapes, and 2) I accept that once or twice a week I’m too tired to start as early as I’d like (so I get more sleep instead). To elaborate:

1) When I restarted the treatment in 2006 after having been hospitalized, I was too depressed to deal with videotaping. In fact, I was too depressed to get out of bed so early. The mirror solved both problems, because I could easily prop it on my mattress top. After a few days I was able to get up, allowing me to listen to music, use bright lights, etc., during the treatment.

2) Whether for lack of discipline or the proper genes, I simply can’t go to sleep early enough so that I can get up early every morning. (Granted, I haven’t tried everything, but for the sake of the argument, let it stand.) This shortcoming used to bother me a great deal. Then on October 6th, 2011, I read in this blog about someone else who didn’t always start the treatment early, because he was “too tired to get up early”. Well! It didn’t seem so bad if someone else had the same problem. Over the years I’ve found that starting 30-60 minutes late once or twice a week doesn’t seem to perturb my mood enough to cause great concern.

I asked how the therapy has helped him. He replied:

The benefits of the morning faces therapy have been both 1) quantitative and 2) qualitative.

1) I have had bipolar disorder for 27 years. With the therapy, I’ve been medication-free for 6 years, and I was on much reduced doses of medication for about 7 years. So it’s fair to say the therapy has reduced the severity of the illness by around one half. Also, the lithium that I took in part caused kidney disease, whereas, obviously, there are no side effects from looking at faces in the morning.

2) The qualitative difference seems far more important to me. I am basically content with life; I am comfortable in my own skin. I’ve never felt like this before, and life without this is empty.

Note to skeptics: you might think, well, bipolar disorder is known to go in remission, and maturity often brings contentment. But this fails to explain why stopping the treatment brings back both the illness and the essential sadness.

I began the morning faces therapy in April, 1997. I can think of only two significant changes over the years in my use of the therapy: 1) I use a mirror instead of videotapes, and 2) I accept that once or twice a week I’m too tired to start as early as I’d like (so I get more sleep instead). To elaborate:

1) When I restarted the treatment in 2006 after having been hospitalized, I was too depressed to deal with videotaping. In fact, I was too depressed to get out of bed so early. The mirror solved both problems, because I could easily prop it on my mattress top. After a few days I was able to get up, allowing me to listen to music, use bright lights, etc., during the treatment.

2) Whether for lack of discipline or the proper genes, I simply can’t go to sleep early enough so that I can get up early every morning. (Granted, I haven’t tried everything, but for the sake of the argument, let it stand.) This shortcoming used to bother me a great deal. Then on October 6th, 2011, I read in this blog about someone else who didn’t always start the treatment early, because he was “too tired to get up early”. Well! It didn’t seem so bad if someone else had the same problem. Over the years I’ve found that starting 30-60 minutes late once or twice a week doesn’t seem to perturb my mood enough to cause great concern.

I recently came across a 2005 survey, done in Texas, that found people with poor sleep were far more likely to be depressed or anxious than people with better sleep. Huge risk ratios:

People with insomnia . . . were 9.82 and 17.35 times as likely to have clinically significant depression and anxiety [than persons without insomnia.]

Other studies have found similar results. For example, a 1979 survey interviewed the same people twice, one year apart. People who had insomnia both times were 40 times more likely to be newly diagnosed with major depression during the intervening year than those who did not have insomnia at either time.

A simple thing to say about the sleep/mood correlation is that it supports my theory of depression, which says depression is often due to malfunction of two circadian oscillators (one controlled by light, the other by faces). If they are working properly (in sync, with large amplitude) you sleep well and are in a good mood when you are awake. If they are not working properly (e.g., not in sync) then you do not sleep well and are in a bad mood at least part of the time while you are awake. What is called depression (e.g., not wanting to do anything) is actually a good thing in the middle of the night. Not wanting to do anything — being still — is necessary to fall asleep.

A sad and more complicated thing about this correlation is that it is ignored. It is not explained by any theory of depression popular among psychotherapists, such as cognitive-behavioral therapy, not to mention a dozen other explanations of depression (psychoanalytic, etc.) that psychotherapists favor. Nor is it explained by any pharmacological theory of depression. In other words, if you seek treatment for depression within our healthcare system the treatment you will receive will derive from a theory that cannot explain this result. Yet the correlation is so strong it must be telling us something important.

You can read endlessly about the high cost of health care. What if the high cost is not the core problem? What if it is only a symptom of something less obvious? What if health care costs a lot because we have a poor understanding of health and disease (as the failure of popular theories of depression to explain the sleep/mood correlation suggests)? What if we have a poor understanding of health and disease because health research is too concerned with allowing healthcare providers to make money?